The new year brings some wonderful things: renewed optimism for the future, resolutions that may or may not be abandoned by February, and plans for a year that seems full of potential. But the dreaded deductible reset also accompanies the new year for many people. Paying for insulin, drugs, and devices at the beginning of the year is often difficult for people whose insurance deductible resets on January first.
Most people get their insurance through their employer, and they may feel that they have to “take or leave” the insurance plan that is presented to them. There are other options, however, and the Affordable Insulin Project can help people advocate for an exemption to the insulin deductible from their employer. Read on to see how what such an exemption does and how to advocate for one or jump to the Affordable Insulin Project page!
What is an Insulin Deductible Exemption?
Many workers are covered by high-deductible insurance plans, which means they are paying deductibles between $1,300 and $7,150 for single coverage and between $2,600 and $14,300 for family coverage. Having a high deductible means that the insurance company may not cover the cost of the worker’s insulin until the they have paid at least $1,300. That can be crippling for some people using insulin.
It doesn’t have to be this way. Insurance plans and employers can exempt some medications from the deductible, meaning some or all of the cost of insulin would be covered by the insurance company regardless of whether the person has met their deductible yet. It may seem like insurance companies and employers have no reason to exempt insulin from deductibles, but in reality the cost of insulin is less than the cost of someone not having access to it and experiencing complications. For instance, if a person with diabetes does not have access to insulin, they could have to go to the emergency room and miss work, and that could cost their employer more than providing the insulin in the first place.
Advocating to Your Employer
The Affordable Insulin Project helps people make this argument to their employer. Employers can make this change to the insurance program they offer any time in the year, so there’s never a bad time to advocate for a change in policy. Most employers do not understand the costs associated with diabetes, so the Affordable Insulin Project includes a Worksheet that provides a place for you to fill in your medical costs and show your employer how difficult it is to afford insulin with such high deductibles. There is also an Employer Guide that you can give to your employer, benefits manager, or HR representative directly, which presents statistics and arguments for an insulin deductible exemption specifically for them. There’s never a bad time to advocate for lower insulin costs. Remember that if you bring this information to your employer, you’re not only helping yourself, you’re helping everyone in your organization who uses insulin.
For Those Without Employer-Based Insurance
People who buy their health insurance off the markets or those who do not have insurance coverage at all are not left out of the Affordable Insulin Project. The site has a page dedicated to copay cards and discount programs for major insulin companies: Lilly, NovoNordisk, Sanofi, and MannKind. These cards and programs can help make insulin more affordable (though you may need to jump through a few hoops!). The Affordable Insulin Project is the first site to put all these resources together, and for many it is invaluable information.